Colorado River Pain Management LLC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

License

26109 Issued in AZ

Legal business name

COLORADO RIVER PAIN MANAGEMENT LLC

Practice address

1951 Mesquite Ave
Suite I
Lake Havasu City, AZ 86403-5746

Phone

(928) 453-3267

Fax

(928) 453-3276

NPI assigned

Oct 23, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Judith A Spillane

Title

Administrator

Phone

(928) 453-3267

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2610/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andres Alvarado, M.D.

  • Anesthesiology Physician
  • Lake Havasu City, AZ
  • NPI 1568456473
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1256256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257379200000",
    "number": "1639405756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1951 MESQUITE AVE",
            "address_2": "SUITE I",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035746",
            "telephone_number": "928-453-3267",
            "fax_number": "928-453-3276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 MESQUITE AVE",
            "address_2": "SUITE I",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035746",
            "telephone_number": "928-453-3267",
            "fax_number": "928-453-3276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO RIVER PAIN MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-23",
        "last_updated": "2009-11-05",
        "status": "A",
        "authorized_official_last_name": "SPILLANE",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "928-453-3267"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "AZ",
            "license": "26109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Lynn Cline, RN
• Richard Ryan Coburn, DMD
• Kimberly Ann Coffey, PHARMD
• Wayne L Cohen, RPH
• Tamra J Coleman, PT
• Community Medical Laboratory, LLC
• Community Medical Services Arizona-Private, LLC
• Community Medical Services Arizona-Private, LLC
• Concierge Health LLC
• Bridget Christine Conley, PA-C

• Pain Clinic/Center in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Pain Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.